Prior art workers have devised many types of ligators, including ligators which apply a knotted loop of gut or synthetic suture material to the tubular member. Such ligators are taught, for example, in U.S. Pat. Nos. 3,687,138; 4,038,988 and 4,050,465.
A great many of the prior art ligators, however, are intended to apply a generally U-shaped clip to clamp the tubular member. U.S. Pat. Nos. 3,777,538; 3,867,944 and 4,027,370 are examples of such surgical devices wherein each clip is individually located in the jaws of the instrument, no magazine or cartridge being used. U.S. Pat. Nos. 3,631,707; 3,774,438 and 3,827,277 are exemplary of those surgical clip applicators utilizing a separate magazine or cartridge. In this instance, the surgical instrument is used to engage and withdraw a clip from the separate magazine, and thereafter to apply the clip to the tubular member.
Prior art workers have also developed surgical ligators having cartridges either built into the instrument or affixed thereto as an attachment. In most instances, the clips are located in the cartridge in end-to-end relationship, one behind the other, feeding legs foremost. This arrangement greatly reduces the number of clips which can be contained in the cartridge. Examples of such instruments are taught in U.S. Pat. Nos. 2,968,041; 3,006,344; 3,082,426; 3,740,994 and 3,844,289. U.S. Pat. No. 3,581,551 teaches a surgical clamp applying instrument having a vertical stack of clamps. In U.S. Pat. Nos. 3,576,288 and 3,592,377 the clips are mounted on and advanced by a threaded member. Finally, U.S. Pat. No. 2,874,384 describes a ligator having a small magazine of clips in face-to-face relationship and extending laterally of the instrument.
The prior art ligators provided with magazines or cartridges of clips are characterized by a number of disadvantages. First of all, the cartridges or magazines are of limited capacity and, in most instances, the orientation of the clips within the magazine or cartridge contribute to this limited capacity. In many instances, a part of the force utilized to actuate the prior art ligators is required to shift a clip to its position wherein it may be applied to the tubular member intended to be clamped. In some instances, wholly separate manipulation of the cartridge or magazine device is required.
The present invention constitutes an improvement over prior art ligators. The ligator herein described is a pliers-like structure having a pair of handle elements terminating at their forward ends in jaw portions. The first handle element contains a magazine for a row of clips arranged in edge-to-edge relationship. The jaw portion of the first handle element has a stop means to properly locate the forwardmost clip of the row in position for use. The jaw portion of the second handle element also has a locator stop. Means are provided within the magazine to constantly urge and advance the row of clips forwardly so that the forwardmost clip of the row will always be in position for use. Thus, no portion of the force required to operate the ligator is used to advance the clips.
The size of the magazine and the orientation of the clips therein enable the provision of a large number of clips within the magazine. The arrangement of the jaw portions is such that the jaws provide front and side containment of the forwardmost clip of the row thereof, while the next succeeding clip in the row (or ultimately the shoe) provides rearward containment for the forwardmost clip. The ligator of the present invention is extremely simple in design and construction and may be provided in both reusable and disposable forms.